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81.
Antonio Espuela‐Ortiz Fabian Lorenzo‐Diaz Adrian Baez‐Ortega Celeste Eng Natalia Hernandez‐Pacheco Sam S. Oh Michael Lenoir Esteban G. Burchard Carlos Flores Maria Pino‐Yanes 《Pediatric pulmonology》2019,54(12):1948-1956
Several studies have shown that the airways of asthma patients contain higher diversity of bacteria and are enriched in pathogenic species. However, sampling the airways in children is challenging. Here we aimed to identify differences in the salivary bacterial composition between African Americans children with and without asthma. Saliva samples from 57 asthma cases and 57 healthy controls were analyzed by means of 16S ribosomal RNA amplicon profiling. Measurements of bacterial diversity and genus relative abundance were compared between cases and controls using the nonparametric Wilcoxon test and multivariate regression models. A total of five phyla and a mean of 56 genera were identified. Among them, 15 genera had a relative abundance greater than 1%, being Prevotella, Haemophilus, Streptococcus, and Veillonella the most abundant genera. Differences between cases and controls were found in terms of diversity, as well as in relative abundance for Streptococcus genus (13.0% in cases vs 18.3% in controls; P = .003) and Veillonella genus (11.1% in cases vs 8.0% in controls; P = .002). These differences remained significant after correction for multiple comparisons and when potential confounders were taken into account in logistic regression models. In conclusion, we identified changes in the salivary microbiota associated with asthma among African Americans. 相似文献
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Laila Cochon Anais Ovalle José M. Nicolás Amado Alejandro Baez 《The American journal of emergency medicine》2017,35(4):564-568
Objective
To assess and compare the diagnostic value of lactate, procalcitonin (PCT) and C-reactive protein (CRP) in low, moderate, and high-risk stratified population applying Mortality in Emergency Department (MEDS) risk score using Bayesian statistical modeling.Methods
MEDS criteria was used to risk stratify into low, moderate and high risk. Each population was attributed a percentage risk, and used as pre-test probability in the Bayesian nomogram. Sensitivity and specificity lactate, PCT and CRP were attained from pooled meta-analysis data. Absolute and relative diagnostic gains were calculated.Results
Pooled diagnostic quality data obtained from a meta-analysis reflected sensitivity for PCT of 77% and specificity of 79%, for lactate sensitivity 49.1% and specificity 74.3% and CRP yielded a sensitivity of 75% and specificity 67%. likelihood ratios (LR) calculations for PCT were LR + 3.67 and LR ? 0.29; for lactate LR + 1.88 and LR ? 0.69; CRP LR + 2.27 and LR ? 0.37. When computed in Bayesian nomogram post-test probabilities for LR + were as follows: for PCT low risk absolute gain of 11.7% and relative gain of 220%; moderate absolute gain 25.7% relative gain 148.5%; for high risk absolute gain 25.1% and relative gain 42.6%. Lactate LR + results for low risk absolute gain of 4.7% and relative gain of 88.6%; moderate absolute gain 10.7% and relative gain 61.8%; high risk relative gain 14.1% and relative gain 23.9%. CRP results for low population and LR + absolute gain 5.7% and relative gain 107.5%; moderate risk 14.7% absolute gain and 84.9% relative gain; high risk 77% post-test 18.1% absolute gain and 30.7% relative gain.Conclusion
Bayesian statistical model demonstrated the superior diagnostic quality of PCT. For ruling out severe disease, lactate yielded a higher benefit with increased relative gain with negative LR. 相似文献84.
Kiran Dhiman MPH Marc Hall MSc CCRP Trafford Crump PhD Alison M. Hoens MSc BScPT Diane Lacaille MDCM MHSc FRCPC James A. Rankin PhD RN Karen L. Then ANCP PhD Glen Hazlewood MD PhD FRCPC Cheryl Barnabe MD MSc FRCPC Steven Katz MD FRCPC Jason Sutherland PhD Erika Dempsey MD MSc FRCPC Claire E. H. Barber MD PhD FRCPC 《Health expectations》2024,27(1):e13978
85.
Laila Cochon Kaitlin McIntyre José M. Nicolás Amado Alejandro Baez 《Emergency radiology》2017,24(4):355-359
Objective
Our objective was to evaluate the diagnostic value of computed tomography angiography (CTA) and ventilation perfusion (V/Q) scan in the assessment of pulmonary embolism (PE) by means of a Bayesian statistical model.Methods
Wells criteria defined pretest probability. Sensitivity and specificity of CTA and V/Q scan for PE were derived from pooled meta-analysis data. Likelihood ratios calculated for CTA and V/Q were inserted in the nomogram. Absolute (ADG) and relative diagnostic gains (RDG) were analyzed comparing post- and pretest probability. Comparative gain difference was calculated for CTA ADG over V/Q scan integrating ANOVA p value set at 0.05.Results
The sensitivity for CT was 86.0% (95% CI: 80.2%, 92.1%) and specificity of 93.7% (95% CI: 91.1%, 96.3%). The V/Q scan yielded a sensitivity of 96% (95% CI: 95%, 97%) and a specificity of 97% (95% CI: 96%, 98%). Bayes nomogram results for CTA were low risk and yielded a posttest probability of 71.1%, an ADG of 56.1%, and an RDG of 374%, moderate-risk posttest probability was 85.1%, an ADG of 56.1%, and an RDG of 193.4%, and high-risk posttest probability was 95.2%, an ADG of 36.2%, and an RDG of 61.35%. The comparative gain difference for low-risk population was 46.1%; in moderate-risk 41.6%; and in high-risk a 22.1% superiority. ANOVA analysis for LR+ and LR? showed no significant difference (p = 0.8745, p = 0.9841 respectively).Conclusions
This Bayesian model demonstrated a superiority of CTA when compared to V/Q scan for the diagnosis of pulmonary embolism. Low-risk patients are recognized to have a superior overall comparative gain favoring CTA.86.
Objective
The objective of our study was to assess the diagnostic quality of low-dose computed tomography (CT) when compared to ultrasound (US) in diagnosis of urolithiasis using STONE score as a predictor of pre-test probability and the Bayesian statistical model to calculate post-test probabilities (POST) for both diagnostic tests.Methods
STONE score was used to form risk groups to obtain pre-test probabilities. Likelihood ratios (LR) were calculated from external data for low-dose CT and US. POST were obtained using pre-test probabilities and likelihood ratios with Bayesian nomogram. Absolute (ADG) and relative (RDG) gains in diagnostic value were calculated.Results
Calculated +LR for US was 12 and ?LR was 0.32; for CT, +LR was 19 and ?LR 0.04. +LR and low STONE for US yielded POST 57% and RDG 470%; intermediate STONE POST 92% and RDG 84%; and high STONE POST 99% and RDG 10%. ?LR and low STONE for US POST 3% and RDG ?70%; intermediate POST 24% and RDG ?52%; and high STONE POST 74% and RDG ?17.7%. +LR and low STONE for CT POST 68% and RDG 580%; moderate STONE POST 95% and RDG 90%; and high STONE POST 99% and RDG 10%. ?LR and low STONE for CT POST 0% and RDG ?100%; intermediate POST 4% and RDG ?92%; and high STONE POST 26% and RDG ?71.1%. ANOVA calculations comparing CT vs US for +LR showed no statistical significance (P value = 0.9893; LR? P value = 0.5488).Conclusion
Bayesian statistical analysis demonstrated slight superiority of CT scan over US on STONE score low- and moderate-risk stratified subtypes, whereas no significant advantage was seen when evaluating high-probability patients.87.
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90.